| NPI | 1154705770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA BIVENS Revenue Cycle Manager 386-274-2977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2024-04-25 |